The Art of Tutoring, Part 1
Well, I was completely screwed. Might as well get back to work. Professor Kim Hyukjae's devilish emoticon (^^) lingered in my mind, but what could I do? Tomorrow's disaster would have to be dealt with by tomorrow's me. Today's me had to survive tonight's shift.
Sitting in front of the station computer, I finished charting the Ohsung fanatic who had nearly grabbed me by the collar and called me a fraud just moments ago. "Writing a single line of a chart shouldn't require this much drama," I muttered, slamming the Enter key before leaning back in my chair. As the adrenaline faded, a crushing wave of fatigue rushed in to take its place.
Even after the Ohsung fanatic left, the ER doors didn't get a single moment of rest. After midnight, the emergency room became a sanctuary for people who were anything but ordinary.
"Doctor! My head is splitting open! I need a brain CT right now!" A man in his thirties, reeking of alcohol, stumbled in, absolutely convinced he was having a brain hemorrhage. When I shone my penlight to check his pupils, he began foaming at the mouth. "Ah, my eyes! The doctor's trying to blind me!" After an hour of back-and-forth, his guardian finally arrived, smacked him hard on the back, asked for a hangover cure prescription, and dragged him out.
Next was a woman in her twenties who was wheeled in clutching her ankle. "I think I twisted my ankle dancing in heels at a club yesterday. I'm sure it's broken! I need an X-ray!" The X-ray was perfectly clean. A textbook sprain. "Ma'am, you just stretched a ligament. Your bones are completely fine." "Liar! How can it hurt this much if it's not broken? Isn't there an orthopedic surgeon here? Are you a quack?" ...Yeah, sure, I'm a quack, lady. I silently wrapped her ankle in a splint and prescribed some Tylenol.
By the time all the chaos finally settled, it was around three in the morning. A temporary lull fell over the station. The first-years, showing no signs of exhaustion, were either waiting for the next patient or flipping through charts to study. Impressive bastards.
Right next to me, first-year resident Baek Eunseo was scrolling through the EMR with bright, sparkling eyes. I wonder when that spark will die out. "Eunseo." At my call, Baek Eunseo bolted upright in her chair, correcting her posture instantly. "Yes, Dr. Han!"
"Aren't you tired?" "Huh? Oh, I'm completely fine!" Baek Eunseo replied, her eyes gleaming behind her glasses. "I think I'm cut out for Emergency Medicine! I'm not tired at all. In fact, my heart is racing! Seeing patients come in, like that appendicitis patient earlier, it just gets my blood pumping!"
...Cut out for it? I doubted my own ears. She only felt that way because she hadn't been dragged through the mud enough yet. Just wait until she pulled a few more all-nighters. Her heart wouldn't be racing; she'd feel like it was about to stop. Unable to bring myself to shatter her innocent illusions with the brutal truth, I stared at her with the glazed, dead eyes of a rotting fish. "I see... Well, I'm exhausted."
"Oh, Dr. Han. Why don't you go lie down in the duty room for a bit..." "Strangely enough, I can never sleep on those duty room beds." That was the truth. I'd rather sit in this uncomfortable station chair than lie down on a mattress reeking of stale sweat and mysterious, musty odors. And besides... I have to actually be able to fall asleep to sleep.
Baek Eunseo hesitated for a moment at my response. Then, as if making up her mind, she thrust a stack of EKG printouts toward me. "Dr. Han! In that case, could you take a look at these EKGs?" I found them online and printed them out to study..." "What is it?" I reluctantly picked up one of the sheets.
"It's a seventy-two-year-old male who complained of mild chest discomfort. But looking at it, there's no ST-segment elevation or depression, and no T-wave inversion... It looks completely normal to me. Am I right?" At Eunseo's naive question, I stared intently at the EKG paper. Normal? This?
"Eunseo." "Yes?" "You don't see this?" I pointed to the T-waves in leads V2, V3, and V4. "They're peaked. And symmetrical. What does this look like to you?"
"Hmm... They are really sharp. How did I miss that?" "They look like tents. Pointy tents. And looking at the shape, this is a textbook presentation of hyperkalemic T-waves." I tapped the paper with the tip of my pen so hard it nearly tore. "If you don't check this patient's potassium levels, you can't complain if they go into V-fib and arrest in a few hours."
"Ah..." I flipped to the next page. "What's this one? An eighty-year-old woman? Presented with dizziness." "It seems a bit slow..." "Don't you think the slowness isn't the real issue here?" I traced the gap between the P-wave and the QRS complex with my pen. "The PR interval. It's incredibly long, isn't it? The baseline is point-two seconds, but this looks well over point-three. It's a first-degree AV block."
"Oh, but I thought we could just monitor a first-degree block..." "Look at this grandmother's chart. Digoxin is on her current medication list. This is the first sign of digoxin toxicity. In this case, you need to immediately order a digoxin level test and stop the medication." Baek Eunseo bit her lip, unable to find any words. I picked up the last sheet. "And this one... *Sigh.*" A sigh escaped my lips. An oddly elevated ST-segment in leads V1 and V2.
"Is this... Brugada...?" "Bingo. Highly suspicious of Brugada syndrome. Even if a patient like this doesn't have symptoms right now, they're a ticking time bomb who could drop dead at any moment. You need to consult Cardiology immediately, get them admitted, and run a thorough workup." I slapped the stack of EKGs down on the desk. Baek Eunseo flinched.
I massaged my stiff neck and said, "Stay sharp. We have to keep our wits about us if we don't want to kill our patients." "...I'm sorry." "No need to apologize. It's good that you're studying in your spare time. If you ever get confused in the future, just bring it to me or one of the other seniors."
I stood up and stretched my stiff shoulders. "Go look at them again. From start to finish. See if there's anything else you missed." "Yes! Understood! Thank you, Dr. Han!" Clutching the stack of EKGs to her chest like a prized possession, Baek Eunseo dove back into the charts with eyes burning with renewed passion.
I stared blankly at her. Just half a year ago, I was looking at EKG printouts thinking, What are these squiggly worm drawings? But being cursed out by those crazy ghost bastards and forced into all-night study sessions had definitely paid off. To think I could now effortlessly answer a first-year's questions. Honestly, I felt like I could probably handle questions from most second- or third-years too.
I emptied another packet of instant mix coffee into a paper cup and returned to my monitor. Miraculously, the station was quiet. Once past three in the morning, the drunkards causing scenes and the patients burning up with fevers had either gone home or been admitted to the wards. All that remained was a bone-deep exhaustion and a backlog of charts to hand over to the next shift.
Beside me, Baek Eunseo was holding the stack of EKGs I had just torn apart, scribbling notes furiously with a red pen. Her eyes behind her glasses showed no signs of fatigue, burning instead with an intense, almost bizarre academic zeal. ...Talk about relentless. I clicked my tongue inwardly. Did this monster not sleep? I worried she might burn herself out and end up crying and submitting a resignation letter in a couple of days. Then again, it was probably that very passion that made her apply to Emergency Medicine even after witnessing that insane open-laparotomy scene.
I stirred my coffee after pouring hot water, blankly refreshing the EMR patient list. Just then, Eunseo called out to me hesitantly. "Dr. Han!" "What now? Did something happen? Which EKG is torturing your brain this time?" I replied without looking up. "Oh, no! It's not that. Um, by any chance..." Baek Eunseo was fidgeting for some reason. That finally made me turn my head. Fiddling with the red pen in her hand, she asked timidly, "Dr. Han. Are you free tomorrow?"
"..." My brain momentarily short-circuited. "Tomorrow? Why? Yeah, I'm off." Tomorrow was my god-given day off. A sacred day where I planned to sleep for twenty hours straight, wake up in the evening, order fried chicken, and binge-watch streaming shows without a single soul disturbing me. Why was this first-year asking about my day off? ...Wait. Is she asking me out on a date? For a split second, I got ahead of myself. No, wait, me? To me, with my dead-fish eyes, smelling of disinfectant and soaked in fatigue? To this fresh, bright first-year?
My mind raced. No way. When I was a first-year, dating was the last thing on my mind. I couldn't even dream of making a move. Back then, I held my breath whenever a senior walked past, and I practically inhaled cup ramen because chewing took too much time. Yet here was a first-year, who hadn't even been here a month, asking out a second-year senior on his day off. What an audacious kid. Hmm... They really do say kids these days are different. Bold, very bold.
Baek Eunseo, unable to read my deadpan expression or the chaotic monologue running through my head, took my silence as a green light. Gathering her courage, she finally got to the point. "In that case, if I run into something I don't understand while studying on my own tomorrow, would it be okay if I asked you?" "...Huh?" A dumb sound escaped my lips. Studying? On my day off? By herself?
"Why? Why me?" I asked before I could stop myself. There were plenty of other perfectly fine second-years, not to mention our fellow Lee Min-jae, or she could just open a textbook—which would probably be faster. Why me, of all people? At my question, Baek Eunseo's face lit up. As if she had been waiting for this exact question, she answered without a second of hesitation. "Well, you're my direct second-year senior! And you're my role model! But most of all, you explain things so well here at the hospital!"
Role model. The corners of my mouth twitched at that single phrase. Well, I suppose I am. Yeah, I was pretty amazing. I caught an MI from a sore throat, performed an open-laparotomy, did a REBOA, and diagnosed TTP. And just now, I gave a masterful lecture on EKGs. With a track record like that, wasn't I more than qualified to be a role model? Fighting to keep my cheeks from splitting into a grin, I adopted the coolest, most nonchalant senior tone I could muster.
"Oh, really? Well... uh... feel free to ask... actually, don't feel free. Make sure you feel extremely burdened when you ask." "Huh?" Eunseo's pupils dilated in sheer confusion. "Just kidding. Ask away." I waved my hand dismissively and turned back to my monitor. This was going to be a pain. My phone was probably going to buzz with messages right in the middle of my chicken feast tomorrow. Yet, a corner of my heart felt strangely tickled. That's right. I can answer anything.
Looking down at my empty coffee cup, a wicked smile crept onto my face. Even if it's something far beyond my actual abilities. I recalled the familiar blue interface that only I could see in my mind. Let her ask whatever she wanted. No matter what she threw at me, I had a study group of deceased medical geniuses from every specialty imaginable, spanning hundreds of years, backing me up. If she asked about EKGs, I could just summon the Cardiology Ghost. If she asked about hematology, I could badger Hematology-Oncology is Hell. All I had to do was copy-paste the correct answers and kindly pass them along to her. I got to maintain my dignified status as a role model. She got her answers. And those crazy ghost bastards got an outlet to dump their medical knowledge. What a perfect, win-win-win ecosystem. Hehehe.